“AGNIKARMA IN ABABAHUKA W.S.R TO FROZEN SHOULDER” DEBASIS.pdf · kundu debasis 1. bhosgikar anup 2. wagmare aswinikumar 3. n g mulimani 4 p g scholar (2nd year) : dept of shareer

“AGNIKARMA IN ABABAHUKA W.S.R TO FROZEN SHOULDER” RESEARCH ARTICLE

PIJAR/VOLUME-I/ISSUE –I /AUGUST-SEPTEMBER-2016 21

“AGNIKARMA IN ABABAHUKA W.S.R TO FROZEN SHOULDER” KUNDU DEBASIS1. BHOSGIKAR ANUP2. WAGMARE ASWINIKUMAR3. N G MULIMANI4

P G SCHOLAR (2ND YEAR) : DEPT OF SHAREER RACHANA,1 ASST.PROFESSOR2. ASST.PROFESSOR3.

PROFESSOR (HOD)4 : DEPT OF SHAREER RACHANA ,N .K. JABSHETTY AYURVEDIC MEDICAL COLLEGE

AND P G CENTRE (KARNATAKA)

Introduction: The term Avabahuka was first

told by Acharya Sushruta8 where he has

described Samprapti (Pathogenesis) and

Rupa (Symptom) of Ababahuka. Both

Ashtang Hridaya and Ashtang Samgraha

have elaborated the full account of

Ababahuka9,10. It is mentioned as one

among the eighty types of vata

nanatmaja vikaras by both

Sharangadhara and Bhavamishra11,12.

Arunadutta and Dalhana, both have

commented on samprapti, lakshana and

treatment of Ababahuka in their

works13,14. In Madhava nidana two

conditions of the disease has been

mentioned15 – Amsashosha and

Ababahuka. Amsashosha can be

considered as the preliminary stage of

the disease where loss or dryness of

Abstract:

The Shoulder Joint in Ayurveda has been described as a type of chala1 and

ulookhala sandhi2 which is formed by the combination of pragandasthi (Humerus),

kshakasthi(Clavicle) and amsaphalakasthi (Scapula). Pratanavatsnayu covers this sandhi3

while Shleshmadharakala is presents in this joint and secretes Shleshmaka kapha4. This

acts as lubricant and helps in protection and movement of the sandhi5 .Amsamarma

which is a snayumarma measuring half finger width6 is present near this Sandhi.

Ababahuka is a disease that usually affects the Amsasandhi (shoulder joint).It is

produced by the Vatadosha. Even though the term Ababahuka is not mentioned in the

nanatmajaVatavyadhi, AcharyaSushruta and others have considered Ababahuka as a

Vatajavikara. Amsashosha (wasting of the shoulder) can be considered as the

preliminary stage of the disease, where loss or dryness of sleshakakapha from

amsasandhi occurs,Patients present with amsasandhishula ,amsasandhisthabdata and

bahupraspanditahara,which can be correlated with the condition of frozen shoulder in

the contemporary science.A constant pain, stiffness and progressive loss of shoulder

motion is termed as frozen shoulder. It affects both active and passive movements of

shoulder joint whether it is flexion, extension, abduction, adduction, external rotation,

internal rotation.

Key words: Ababahuka ,Frozenshoulder,Agnikarma



Sleshmaka kapha from amsa sandhi

occurs. In the next stage i.e.,

Ababahuka, due to the loss of

shleshmakakapha symptoms like shoola

during movement, restricted movement

etc are manifested.

Frozen shoulder is a painful and

disabling condition that often causes

great frustration for patients and care

givers due to slow recovery. The specific

cause of frozen shoulder is not yet

detected. However this condition may

be induced due to certain risk factors

such as:

• Diseases: People suffering from

stroke, diabetes mellitus, heart diseases,

lung diseases, connective tissue

diseases, shoulder conditions like calcific

tendonitis, rotator cuff tear, thyroid

problems may be overactive thyroid

(hyperthyroidism) or an underactive

thyroid (hypothyroidism), breast cancer,

immobility, seizures, accidents, shoulder

injury or surgery, rheumatoid arthritis,

autoimmune diseases, cervical disc

diseases of neck etc.

• Aging influence: The people

belonging to 4th or 5th decade are more

susceptible for this disease especially

women as these people are more prone

for fall, decrease in bones strength &

density, loss of calcium and minerals,

injuries.

• Immobilization: Any previous

injury or surgery, after surgery idleness

or repose stage may cause inefficiency

to move the shoulder joint which may

also become a leading cause of frozen

shoulder.

• Trauma: A mild trauma to the

shoulder also act as a trigger for frozen

shoulder

Symptoms occur

slowly, in three

phases. These

phases are named

according to the

symptoms that

developed gradually.

So these phases are

pain or freezing stage, stiffness or

frozen stage and lastly resolution or

thawing stage.

1st stage: Pain or

freezing stage: It is the

initial stage of adhesive

capsulitis, in this pain is

the cardinal factor

which may get

enhanced with any

movement of limb or soma It may get

worse at night or in cold weather and

may last for several weeks to months.

2nd stage: Stiffness or frozen stage: It

is the succeeding stage of shoulder

contracture as the name suggests, in

this range of motion of the shoulder

joint is limited i.e the shoulder gets

stiffed or frozen.The most astonishing

feature of this phase is that pain is self

resolving in nature while period of this

stage may last up to 1 year.



3rd stage: Resolution or thawing

stage: It is the ultimate stage of the

frozen shoulder which apprise that the

range of gleno-humeral joint begin to

improve over time. This process will

take time, sometime several years and

may last up to 3 years.

AIMS AND OBJECTIVES:

To find out the effective ayurvedic

remedy for frozen shoulder as because

there is no effectiveremedy in allopathic

medicine in spite of

medication,arthroscopic surgery and

physical therapy.

CASE STUDY:

In this connection i studiedten

cases of frozen shoulder in different

agegroup treated by me with agnikarma

(cauterization).

Patient history: They are treated

previouslyby contemporary allopathic

medicine under the surveillance of a

private medicine doctorbefore 6 to 8

months. The history also suggested that

the patient had received oral analgesic

and muscle relaxant drug also. But there

was no satisfactory relief.

Diagnosis: After careful examination

patients are diagnosed as ababahuka

(frozen shoulder), and patient himself

was willing for Agnikarma

(Cauterization) therapy.

Past medicinal history: No such

Past Surgical history: No such

Family history: Nothing significant

On examination: pain, slight swelling,

limitation of movement in shoulder

region.

Investigation:

X ray report: such as arthritis.

Magnetic resonance imaging (MRI) and ultrasound: images of problems with soft tissues, such as a torn or tear of rotator cuff. Diagnosis: Based on clinical presentation

PROCEDUREOF

AGNIKARMA(CAUTERIZATION):

First of affected side of shoulder

regionare cleaned by

Triphalakasaya,then wipedwith dry

sterilized cotton gauze, after that red

hot PanchDhatuShalaka (electro-

cauteryhaving filament like tools)

making Bindu Dhahan.At last application

ofJatyadi Ghrita or rubbing of

gritokumaripatra (alovera) for reducing

the burning sensation.

TREATMENT:

Agnikarma (Cauterization) was done three times in a month at aninterval of 10 days. After completion of 3rdsitting patient got complete relief fromsuch problem. Also given some ayurvedicoral medicine like naradiyalaxmivilas2pill bd with Luke



warm water,mrityunjoy rasa-2 pill bd with Luke warm water andrasnasaptakkasaya-4tsf in empty stomach in themorning & evening. No adverse effects were being observedthroughout the entire sitting. To observeany recurrence of symptoms patientsare followed up to 3 months but recurrenceof symptoms were not observed. Patientwas fully satisfied with Agnikarma (Cauterization) therapy as compared to previoustreatments done with modern modalities.

DISCUSSION:

Cauterization in Ayurveda is

otherwiseknown as Agni karma. Agni

means fire and karma means a process.

Thus, Agni karma is a therapy, which

involves fire and is known as

cauterization in Ayurveda. Again Agni

karma can be termed as Dahan Karma

and it is a process in which the

pathological body comes out or tissue is

cauterized or even damaged with a hot

iron, an electrical current. Among the

number ofvataroga,ababahukais one of

them.Wherevatadoshasget lodged in the

skandhaand causes

pain,swelling,limitation of movement

which is compared with frozen shoulder.

In modern therapy side effect of steroid

therapy is may cause tissue damage or

damage inside the joint numbness in the

shoulder will occur immediately

following the injection steroid reduces

the body's immune system, burning

sensation tenderness, swelling around

the injected area, scarring/infection,

persistent redness/erythema

Mode of action of agnikarma:

(Cauterization) normally, it is therule of

the body that whenever a local tissueis

burnt, the metabolic process in that

placeimproves. Therefore, a variety of

metabolicand regenerating alterations

occurs at theplace, which consequently

leads to improveddemand of oxygen

and nutrition ofthe tissues at the place,

where the heatstrikes. It also eliminates

the undesirable substances and poison.

For these a ford said qualities,

agnikarma (Cauterization) thereby were

chosen for this case and the result was

really very encouraging.

CONCLUSION:

Classical agnikarma

(Cauterization) there by and internal

medication were foundhighly effective to

reduce almost all complaintsof

ababahuka (frozen shoulder).After

reviewing and applying the agnikarma

(Cauterization) in frozen shoulder, it is

notedthat it will not reoccur again, if it

has been cauterised properly.

Agnikarma (Cauterization) therapy is an

OPD procedure. Thusfrom the above

study it can be concluded that

Agnikarma (Cauterization) procedure

proves to be an easy, safe,

uncomplicatedand economical way to

reduce the ababahuka.



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Source of Support: NIL

Conflict of Interest : None declared

CORRESPONDING AUTHOR

DEBASIS KUNDU P G SCHOLAR (2ND YEAR), DEPARTMENT OF SHAREER RACHANA, N K JABSHETTY AYURVEDIC MEDICAL COLLEGE AND HOSPITAL AND P G CENTRE .BIDAR (KARNATAKA)- 585403 E MAIL: [email protected]

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“AGNIKARMA IN ABABAHUKA W.S.R TO FROZEN SHOULDER” DEBASIS.pdf · kundu debasis 1. bhosgikar anup 2. wagmare aswinikumar 3. n g mulimani 4 p g scholar (2nd year) : dept of shareer